Diabetes-proof your sleep

1. High blood glucose levels

Experiencing prolonged high blood glucose levels or hyperglycaemia, can damage your nerve fibres, resulting in a condition called peripheral neuropathy. People who have this diabetes-related complication may experience burning, shooting pain; the sensation of pins and needles; and numbness or weakness in their extremities – all of which tend to get worse at night. Another nerve condition, autonomic neuropathy, affects the nerves that control automatic functions such as breathing and cardiovascular function, digestive processes and continence. This can result in symptoms such as night sweats or needing to go to the bathroom several times a night.

HOW TO MANAGE IT:

The first step is to try to keep your blood glucose levels in check – this can prevent or delay nerve damage or stop further progression. Mild symptoms can be relieved with over-the-counter, non-steroidal anti-inflammatory medications, while more serious symptoms may require prescription medication.

2. Low blood glucose levels

Low blood glucose levels, or hypoglycaemia, can be a major cause of sleep disruption. Waking up in the middle of the night with hypo symptoms – feeling sweaty, hungry, dizzy and light-headed – makes it difficult to get a good night’s sleep. Your body produces stress hormones in response to the low blood glucose, which can make you more resistant to insulin and ultimately lead to further difficulties in managing blood glucose levels. The next day, you may find yourself grappling with unusually high BGLs, fatigue and mental fogginess, which keeps the vicious cycle going. In extreme cases, night-time hypos can result in seizures, comas or even fatalities.

HOW TO MANAGE IT:

There are a number of strategies your care team can put in place to prevent hypos, from changing the timing of your insulin injections or the type of insulin you are using, to improving your injection technique or changing your diet, meal or exercise times.

3. Sleep apnoea

Sleep apnoea affects up to five per cent of the general Australian population and about one in four men over 30. Sleep apnoea can cause you to wake as often as 30 times an hour. This happens when the tongue and other soft tissues in your throat relax and obstruct your airway. Oxygen levels drop, signalling the brain to rouse the body to start breathing again. These oxygen dips also prompt the release of stress-related hormones such as cortisol and inflammatory substances that interfere with glucose metabolism. Interrupted sleep also means that people with obstructive sleep apnoea feel tired during the day and are at a greater risk of health problems, including heart disease.

HOW TO MANAGE IT:

Some people with mild sleep apnoea experience an improvement if they lose weight and stop smoking,’ For others, sleep apnoea is caused by the jaw’s position when asleep. If you think this may be the case, make an appointment with a dentist or orthodontist who can fit you with an oral device. If the sleep study reveals that you have a more severe form of apnoea, and making lifestyle changes doesn’t improve your symptoms, then you may need a continuous positive airway pressure machine (CPAP). Ask your GP for more information.

4. Restless legs syndrome

For people with restless legs syndrome (RLS), bedtime can be a nightmare. Your legs begin to burn or feel prickly and the sensations are only relieved when you get up and move. Because symptoms strike mostly at night, people with RLS are robbed of sleep.

HOW TO MANAGE IT:

Correcting vitamin B12, magnesium and iron deficiencies may help some people control their symptoms. Reducing caffeine and alcohol intake, and stopping smoking, can also help. If these lifestyle changes don’t work, you may require prescription medication.